Mitral Valve Regurgitation

Mitral valve regurgitation, also referred to as mitral regurgitation, is a heart condition in which the mitral valve does not close completely, allowing blood to flow backward into the left atrium.

About Mitral Valve Regurgitation

The heart has four chambers, with two collecting chambers (atria) and two pumping chambers (ventricles). Four different valves of the heart control the flow of blood through the heart. The mitral valve is the valve that sits between the left atrium and the left ventricle.

A normal mitral valve is made up of two thin leaflets (flaps) and the valve opens to allow blood to flow from the left atrium to the left ventricle and closes to keep blood from leaking back into the atrium. Mitral regurgitation occurs when there is a defect in the mitral valve that allows leakage of the blood back into the left atrium. Mitral regurgitation can result from congenital defects of the mitral valve, damage to the mitral valve caused by an infection, or the enlargement of the left side of the heart due to other heart defects that have caused stretching of the mitral valve, which leads to leakage of blood.

Symptoms of Mitral Valve Regurgitation

Symptoms of mitral valve regurgitation vary depending on the severity of the leakage as well as how slowly or quickly the leakage has developed.

Symptoms of mitral regurgitation may include:

• Dizziness
• Fatigue
• Irregular heartbeats or palpitations
• Shortness of breath
• Tiring easily during exercise (for babies, this includes during feeding)

Diagnosing Mitral Valve Regurgitation

During physical examinations, the doctor listens to the patient’s heart and lungs and may detect a heart murmur, which are extra sounds heard throughout the cardiac cycle due to increased blood flow. If your doctor suspects increased blood flow, a recommendation to see a cardiologist may be made. Your doctor may also refer you to a cardiologist if the patient is breathing fast, has poor exercise tolerance (for babies, this includes poor feeding), or has an enlarged liver.

Tests performed when diagnosing mitral regurgitation may include:

• Cardiac MRI or CT Scan: A cardiac MRI or CT scan is used to take more detailed images of the heart to help define the anatomy and detect anomalies, such as the amount of amount of valve leakage.
• Chest X-Ray: A chest X-ray produces an image of the tissue and bones in the heart and lungs and helps your provider assess the shape, size, and structure of the heart and lungs as well as the aeration of or any congestion in the lungs.
• Echocardiogram: An echocardiogram uses ultrasound technology to create a moving image of the heart and its valves, allowing your provider to assess the structure and function of the heart. An echocardiogram also helps provide information about blood flow and how well the heart is pumping blood.
• Electrocardiogram (ECG or EKG): An electrocardiogram uses electrodes that are placed on the body to record the electrical activity taking place in the heart. An ECG/EKG test helps detect abnormal rhythms, such as cardiac arrhythmias, stress on the heart, and damage to the heart muscles.

Treating Mitral Valve Regurgitation

Treatment options for mitral valve regurgitation are dependent upon the cause and severity of the leakage. When mitral regurgitation becomes severe and begins to cause symptoms of heart failure, your doctor may recommend valve replacement or repair. This procedure can be performed using either open-heart surgery or minimally invasive surgery known as transcatheter mitral valve repair or replacement (TMVR), which involves accessing the valve via an artery in the groin under monitored anesthesia.

Treatment options for mitral regurgitation may include:

• Medications: The leakage of the mitral valve may be treated with medications to help the left ventricle pump better so that less blood leaks through the valve. If the valve leakage is causing arrhythmias, medication may also be prescribed to control the heart rate.
• Surgery: If surgery is required, an individualized treatment plan will be created for the patient and the type of surgery will be dependent upon the cause of the regurgitation. While preserving the valve is top priority, the valve may need to be surgically replaced with an artificial valve.

After surgery, the patient will need time to rest and recuperate at home, and activities may be limited. Patients will be guided through a personalized rehabilitation program to help safely and effectively build strength and endurance and regain physical abilities. Once the patient's cardiologist approves, they should be able to resume normal activities.

Care Team Approach

Patients are cared for by a dedicated multidisciplinary care team, meaning the patient will benefit from the expertise of multiple specialists across a variety of disciplines. Our board-certified and fellowship-trained heart surgeons have extensive experience treating patients with heart disease and vascular disorders and work alongside a team of cardiac experts, including cardiologists, interventional cardiologists, electrophysiologists, critical care specialists, hospitalists, anesthesiologists, perfusionists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical and occupational therapists, pharmacists, and more, providing unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating the patient’s care with referring physicians and other partners in the community to ensure that we are providing comprehensive, whole-person care.

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